Reimbursement


DME MACs Instructed to Deactivate Accreditation Edit

Claims should no longer deny due to accreditation error.

CMS Issues Reminder of New ABN Form

New form must be using starting Nov. 1.

Texas Providers Protest Proposed Medicaid Cuts

Additional DME reimbursement cuts would range from 6 to 26 percent.

Funding Essentials

Whac-A-Mole, Anyone? Medicare & Medicaid Challenges

CMS: Still No PECOS Implementation Date

Reminder bulletin says ordering/referring provider claim edits still not being applied.

CMS Updates Power Chair Rental FAQs

Question topics include breaks in service and repair/replacement policy.

CIGNA Changes Name to CGS LLC

Web site url for Jurisdiction C DME MAC also changes June 1.

NGS Issues Overpayment Process Reminders

Jurisdiction B DME MAC says overpayments are being sent to wrong addresses or using wrong forms.

CMS Publishes Face-to-Face Exam Checklist

MLN Matters article seeks to help improve documentation compliance.

NGS Announces Prepay Review for Intermittent Catheters

HCPCS code A4353 is affected.



NGS Reports 70% Error Rate in K0823 Reviews

Lack of documentation is cited as key error.

Suppliers Reminded of "Home" Definition for DME

DME MACs are fielding more inquiries on place of service.

Policy Revision to Allow ABN Usage on Group 2 POVs, Group 4 Power Chairs

Still deemed not medically necessary by Medicare, vehicles will qualify for ABN use in the future.

Funding Essentials

Avoiding KX Modifier Mix-Ups

H.R. 1041 Co-Sponsor List Tops 80, as Competitive Bidding Criticism Continues

Repeal effort gains support; auctions expert calls program "fatally flawed."

Survey: Medicare Policies Hurting Mobility Providers, Beneficiaries

Competitive bidding, standard power rentals, audits are affecting service and access.

Bill to Repeal Competitive Bidding Gains Momentum

AAHomecare reports 53 cosponsors in bill's first three weeks.

SC BlueCross Acquires CIGNA Government Services

Jurisdiction C DME MAC is included in acquisition.

NHIC Announces Results of K0823 Prepayment Review

Claims reviews to continue for standard power chairs.

NGS to Conduct Prepayment Probe for Group 2 Support Surfaces

Random claims to be checked for medical necessity, documentation requirements.

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